Healthy Water Association

THE MAGNESIUMONLINE LIBRARY

Migraines

From the Rodale book, Prevention's Healing with
Vitamins

While vitamin and mineral supplements are by no means the
first line of treatment for migraines, there are a couple of
therapies that just might work when all else fails. Here's what
some experts recommend.

NUTRIENTS, DAILY AMOUNTS, AND APPLICATIONS

MEDICAL ALERT!

Doses for these two therapies are extremely high. If you wish
to try these supplements to treat migraines, you should discuss
it with your doctor.

People who have kidney or heart problems should supplement
magnesium only under medical supervision.

Ending the Pain

The hammering inside your head is utterly horrendous, as if
someone were using your brain for a bongo. For what it's worth,
you're not the only one with a built-in percussion section:
Roughly 45 million Americans reportedly suffer from headaches
each year.

Although tension headaches are by far the most common, chronic
migraines are much more likely to send a desperate individual to
the doctor seeking relief. "I use the term victim when I refer to
chronic headache sufferers, because it's a very wicked syndrome,"
says Burton M. Altura, M.D., professor of physiology and medicine
at the State University of New York Health Science Center at
Brooklyn. "Besides the agonizing pain, these folks often have
tremendous sensitivity to light and noise. Just snapping your
fingers or clapping around them can be excruciating."

The one-sided, throbbing headache known as a migraine is
actually more common in women; roughly 75 percent of those who
get migraines are female. But what migraines lack in gender
equality they make up for in severity. Some migraines are so
extreme that they cause limb numbness, hallucinations, nausea and
vomiting.

The good news is that medical research has come up with
several vitamin and mineral therapies that might prove helpful
for people who have been unable to find relief elsewhere.

"B" Headache-Free

Fifty-two quarts of chocolate syrup. Nine hundred bowls of
cornflakes. These might prevent a migraine--if they weren't
guaranteed to give you a stomachache first. They add up to a
superhigh dose of riboflavin, which research hints may ward off
the someone's-put-a-soccer-ball-in-my-head pain.

Fortunately for the 49 people in a Belgian headache study,
they were able to take supplements to get the necessary
400-milligram daily dose. The migraine-prone people in the study
received this high dose (it's about 235 times the Daily Value)
every day for three months. In addition to the riboflavin, 23 of
the people in the study took one low-dose aspirin a day.

By the end of the study, migraine severity decreased by nearly
70 percent in both groups compared with what it had been at the
study's start. Aspirin had no added value.

Why would something like riboflavin work? Researchers have
noticed a deficit in certain energy generators in the brain cells
of some people with migraines. They suspect that flooding the
system with riboflavin could indirectly help regenerate this
flagging energy system and somehow short-circuit migraine
pain.

What's attractive about riboflavin, if rigorous scientific
studies support these preliminary findings, is that it's likely
to have fewer side effects than current headache preventives
(although no one knows for sure the long-term effects of this
much riboflavin).

"I wouldn't use it as the first line of attack, because we
have other agents of proven value," says Seymour Solomon, M.D.,
professor of neurology at Albert Einstein College of Medicine in
New York City. "But since this appears to be a relatively
harmless treatment, it would be worthwhile to explore it with
patients who haven't responded well to standard therapy."

Although riboflavin generally is quite harmless, it's a good
idea to check with your doctor before supplementing in such a
high amount.

Making the Magnesium-Migraine Link

An increasing number of doctors believe that some of the most
severe cases of migraines may actually be caused by an imbalance
of key minerals such as magnesium and calcium.

"Not all headaches are produced by this imbalance, but we now
know that 50 to 60 percent of migraines are magnesium-linked. And
that's probably why no prescription therapy on the market
successfully treats headaches across the board. They're simply
not treating the cause," says Dr. Altura.

"Of the 17 people we've treated with magnesium, 13 have had
complete improvement," says Herbert C. Mansmann, Jr., M.D.,
professor of pediatrics and associate professor of medicine at
Jefferson Medical College of Thomas Jefferson University in
Philadelphia.

The magnesium-migraine link still is not commonly accepted by
headache experts. In fact, Dr. Altura says that one of his
magnesium studies was rejected by a prominent medical journal at
the suggestion of a top headache researcher. (Shortly thereafter,
the study was published by another journal.) But the weight of
evidence for magnesium's use in the treatment of migraines is
building. "There's no question that the literature strongly
supports it," says Dr. Mansmann. "The so-called headache experts
don't believe the data because they don't know anything about the
development of magnesium deficiencies within cells."

To understand why magnesium might do the trick, it helps to
take a look at how migraines happen.

Migraines are thought to be caused by vascular changes, or
changes in the blood vessels, that reduce blood or oxygen flow in
the scalp and brain. What causes these vascular changes? Things
such as muscle contractions during times of stress and
biochemicals called catecholamines and serotonin, which are
circulating in the blood. Too much serotonin can cause blood flow
to slow; too little can cause blood to move through too rapidly,
explains Dr. Altura.

While mainstream researchers have long known that changes in
serotonin and catecholamine levels cause migraine pain, stopping
these changes has been a hit-or-miss proposition, says Dr.
Altura. An aspirin, for example, temporarily inhibits the effects
of serotonin but does nothing to prevent a migraine from coming
back, he says.

Dr. Altura says he's the first to prove that loss of magnesium
from the brain is behind the problem. Without enough magnesium,
serotonin flows unchecked, constricting blood vessels and
releasing other pain-producing chemicals such as substance P and
prostaglandins, he says. Normal magnesium levels not only prevent
the release of these pain-producing substances but also stop
their effects, says Dr. Altura.

It's very likely that magnesium deficiency is a widespread
cause of migraines, maintains Dr. Mansmann. Studies show that
many people don't even come close to getting the Daily Value of
magnesium, which is 400 milligrams. "On a daily basis, 30 to 40
percent of American people take less than 75 percent of the Daily
Value of magnesium," says Dr. Mansmann.

What's more, several different things, from the caffeine in
just two cups of coffee a day to the chemicals in most asthma
medications, remove some magnesium from your system. "We know
that intake is low for a lot of people. We know that a lot of
medications, such as diuretics (water pills) and a variety of
cardiovascular medications, can increase magnesium losses. We
know that people with diabetes who have high blood sugar lose a
lot more magnesium in the urine and, as a result, run the risk of
magnesium deficiency," says Karen Kubena, Ph.D., associate
professor of nutrition at Texas A & M University in College
Station. Even stress, a frequent cause of migraines, can remove
magnesium from your system, says Dr. Mansmann.

According to his records, Dr. Altura says that about 50 to 60
percent of his migraine patients have low magnesium levels. But
once they begin treatment, he says, they often experience
immediate relief. "We can say that 85 to 90 percent of these
patients are successfully treated, and that's pretty miraculous,"
says Dr. Altura.

So can getting more than your share of magnesium every day
prevent migraines? Dr. Altura says it's still unclear. "I'd like
to be able to answer that question. I can't at this point, but my
guess is that it would," he says. In Dr. Mansmann's experience, a
magnesium gluconate supplement works best. "The advantage is that
dose for dose, magnesium gluconate causes one-third of the amount
of diarrhea that magnesium oxide produces and one-half of the
frequency of diarrhea that magnesium chloride produces," he says.
It's also absorbed more quickly, he says.

The difference: Magnesium gluconate is more biologically
active. "The active form of magnesium is ionized magnesium. When
a substance is chemically bound, it's sort of neutralized, if you
want to use a Star Trek term. When it's ionized, it is available
to do what it is supposed to do, which in this case is possibly
prevent constriction of blood vessels in your brain and scalp,"
explains Dr. Kubena.

Dr. Mansmann's migraine patients take two 500-milligram
magnesium gluconate tablets at lunch, two in the afternoon and
two at bedtime, upping the dosage each week until their stools
become soft, an indication that there is enough magnesium in the
body.

If you decide to give this therapy a try, you should be
working with a doctor who is willing to monitor your progress.
(People who have kidney or heart problems should supplement
magnesium only under medical supervision.) You'll have to pay
attention to your calcium intake as well.

The Calcium Connection

Even if you monitor your magnesium level like a maniac, you're
still at risk for migraines if your calcium level is out of
whack. The reason: Magnesium and calcium interact with each
other.

It seems that higher than normal blood levels of calcium cause
the body to excrete the rest, which in turn triggers a loss of
magnesium.

"Let's say you have just enough magnesium and too much calcium
in your blood. If calcium is excreted, the magnesium goes with
it. All of a sudden, you could be low in magnesium," says Dr.
Kubena.

In fact, says Dr. Altura, people who have low magnesium and
elevated calcium levels are among those who are most successfully
treated with magnesium.

Food Factors

A host of foods contain chemicals that can cause severe
headaches. Here's what nutrition experts say to avoid.

Say no to MSG. A flavor enhancer used in restaurants and in
prepared foods such as soups, salad dressings and lunchmeats,
monosodium glutamate (MSG), even in small amounts, can provoke
severe headaches as well as flushing and tingling in
headache-prone people, says Seymour Diamond, M.D., director of
the National Headache Foundation and director of the Diamond
Headache Clinic in Chicago. In fact, one study showed that
roughly 30 percent of those who eat Chinese food suffer these
same symptoms. Although more research needs to be done, MSG seems
to act as a vasodilator, which means it opens and then closes the
blood vessels in the head. This process is exactly what happens
in a migraine.

Because of all of the bad press, spotting MSG on food labels
is harder than ever. "Natural flavor" and "hydrolyzed vegetable
protein," for example, substitute for MSG in everything from
frozen dinners, potato chips and sauces to canned meats.

Nix the nitrites. Commonly used as a preservative in hot dogs,
salami, bacon and other cured meats, nitrites have been known to
provoke migraines, says Dr. Diamond.

Corral the caffeine. The experts are divided here. Coffee,
cola and tea all contain caffeine, which can act as a
vasoconstrictor and, as a result, limit blood flow through the
blood vessels in your head.

"A little bit of caffeine may help a headache, but you get
either withdrawal or a rebound phenomenon from having too much,"
says Herbert C. Mansmann, Jr., M.D., professor of pediatrics and
associate professor of medicine at Jefferson Medical College of
Thomas Jefferson University in Philadelphia. Still, even two cups
of a caffeine-containing beverage a day removes precious
magnesium from your system, he says.

The bottom line: If you're having a problem with migraines,
try avoiding caffeine and see if it helps, advises Dr.
Mansmann.

Consider aspartame. Although few studies show a direct link
between this artificial sweetener and headaches, some people do
report problems with it, says Dr. Diamond. "My advice to people
is that it probably won't bother you, but if you can relate a
headache to it, you should not use it," he says.

To test whether this or any other food is causing your
headaches, keep a diary of your meals as well as any headaches
for a month. If it looks like one of the foods you're eating is
causing the problem, cut it out of your diet and see if it helps,
advises Dr. Diamond.

Ban the booze. The alcohol in drinks can dilate the blood
vessels in your brain and cause a headache, warns Dr. Diamond.
And drinking hard liquor can give you a double whammy. Chemicals
known as congeners as well as impurities in scotch and other hard
liquors have the same effect, he says.

This page was first uploaded to The Magnesium Web Site on
November 23, 2002